Individual provider Active NPI

Imani Colbert, MSW

  • Clinical Social Worker
  • Upper Marlboro, MD
National Provider Identifier
1306327762
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20857 Issued in MD
Practice address
13803 Pintail CT
Upper Marlboro, MD 20774-7106
Phone
(240) 462-3914
NPI assigned
Aug 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 20857 MD Primary

Addresses

Primary practice location

13803 Pintail CT
Upper Marlboro, MD 20774-7106

Mailing address

13803 Pintail CT
Upper Marlboro, MD 20774-7106
Phone (240) 462-3914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20857MDMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1306327762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13803 PINTAIL CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747106",
            "telephone_number": "240-462-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13803 PINTAIL CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747106",
            "telephone_number": "240-462-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBERT",
        "first_name": "IMANI",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "20857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.